Human Anatomy at Colby

Entries Tagged as 'Guest Speakers'

Anonymous Student: Circumcision

February 23rd, 2015 · Comments Off on Anonymous Student: Circumcision

 

Dr. Peter Millard recently came in for a talk about HIV and preventative measures in Africa, specifically discussing circumcision and its effects in nations severely affected by HIV within Africa. Dr. Millard actively supports circumcision and has equated the procedure with vaccination. There are serious issues with this claim. Circumcision and vaccines can not be equated. The amount of mental acrobatics it requires to compare a quick needle stick with a 15-minute unanesthetized surgical alteration of the genitals is ridiculous. Unlike vaccinations, botched circumcisions are common. Immunization prevents disease but circumcision is 100% chance of mutilation (Rebecca Grey). Vaccination also does not deprive an individual of any functional body parts. The foreskin is not just skin as Dr. Millard alluded. It is composed of mucous membrane, also called a prepuce, analogous to the eyelid or the inside of the mouth. People designated female at birth have a foreskin equivalent called the clitoral hood which evolved from the same tissue as the foreskin. Circumcision within US history has been tied to various fleeting reasons. The procedure was popularized by Dr. Kellogs during the Victorian era (the same person who co-invented corn flakes) to curb masturbation. He said:

“ The operation should be performed by a surgeon without administering an anæsthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment.”

This masturbation hysteria was then replaced by fear of sexually transmitted infections followed by prostate cancer, and now urinary tract infections. Parents believe that circumcision helps with cleanliness, but they do not realize that there is something called a bath or a shower. Taddio et al. performed a meta-analysis observing the pain responses to subsequent vaccinations of circumcised infants and uncircumcised infants. They found that circumcised infants showed a stronger pain response than uncircumcised infants. The trauma of circumcision has lasting effects on these children. This logic of removing a functional body part to prevent disease is the same as selling a car to prevent a car accident (Men’s Health). Safe sex practices are what stops HIV transmission.

Dr. Millard mentioned that circumcision decreased transmission of HIV by 50-60%, but did not mention that a vaccine has essentially a 95% efficacy rate. Vaccination is about immunization, circumcision is not about immunization. The US has the highest HIV transmission of all the westernized countries and the highest circumcision rates. Evidence points to insufficient education about safe sex practices. In 1992, 410,00 cases of chlamydia was reported, 20 years later, 1.3 millions cases were reported. In 2000, there were 31,618 cases of syphilis, 10 years later, 45.834 cases were reported. It seems sex education among the general population is low. Instead, doctors are telling parents to circumcise their children instead of teaching children safe sex practices. Media now takes over where various sitcoms commonly have circumcision as a plot device which actively shames those who are not circumcised. Circumcision has become naturalized and not questioned.

Within the US, infant circumcision is still endorsed and is now supported by the WHO and the CDC which is backed by data from adult circumcisions in African countries performed on “consenting” adults. Infant circumcision forcefully separates the fused foreskin from the glans which results in the tearing of the synechia (the tissue that connects the foreskin to the glans) and keratinization of the affected areas. Circumcision is commonly used as treatment for phimosis, but infants can not get phimosis as their foreskins are not naturally retractable. The loss of protective mucosal membranes and various nerves denies the child of their own bodies and decisions. Before a child can even consent to having sex, they have their bodies permanently altered.

The voluntary medical male circumcision in African countries which is backed by the WHO is packaged with connecting men to health care, access to safe sex education, condoms, HIV testing, counselling services, and links to HIV care and treatment. These incentives behind the procedure drive safe sex practices which prevent HIV transmission. Proper habitual condom-use alone prevents HIV transmission by 95%. Circumcision can not be considered voluntary when access to safe sex tools and practices that prevent HIV are contingent upon this procedure. The institutionalized industry of circumcision is backed by ministers of health, policy makers, program managers, health care providers, and donors (e.g. PEPFAR and the Bill and Melinda Gates Foundation) who fund supporting programs. HIV transmission can also be transmitted through circumcision if the tools are not sterilized. Stopping circumcision means stopping access to health care. Of course the HIV transmission rates decrease when patients are educated on safer sex practices. The studies done in Africa were decided to be unethical after two years, but did not mention the unethical issues behind the actual circumcision itself. Long term follow-up should be required for these patients.

The exporting of circumcision results in growing acceptance of this procedure “in communities, among men and their partners, adolescents and parents” (WHO). Although studies have been done on adult men, the WHO supports influence on adolescents who are not given complete informed consent especially when their parents and the institutions manipulating the conditions favor circumcision. Many nations curtail to the US when it comes to health policies. Circumcision has become tool to normalize and impose Western standards of bodies on peoples that can not fully consent.

Circumcision in African countries are funded by western imperialism which exports this practice outside to different nations only to import the “results” back into their own countries to continue non-consensual practice of genital mutilation. This dangerous cycle impacts bodies in very specific ways to normalize cognitive dissonance. Babies do not have consent over circumcision. Continued practice of circumcision normalizes a dangerous environment for those designated male at birth. Why must this procedure be made by doctors paid to cut off foreskin? The infant has no agency over their bodies. Circumcision is a practice that attempts to manage disease, but does not answer the question of how disease can best be managed. Cultural bias coming from Dr. Millard reflects normative nontherapeutic circumcision sentiments within the US.

 

Sources

  1. https://www.psychologytoday.com/blog/moral-landscapes/201109/more-circumcision-myths-you-may-believe-hygiene-and-stds
  2. http://www.ncbi.nlm.nih.gov/pubmed/9057731
  3. http://pediatrics.aappublications.org/content/early/2013/03/12/peds.2012-2896.full.pdf
  4. http://www.parenting.com/blogs/pop-culture/shawn-parenting/circumcision-vaccine-against-bad-parenting
  5. http://www.cbsnews.com/news/circumcision-rates-declining-health-risks-rising-study-says/
  6. http://www.who.int/hiv/topics/malecircumcision/male-circumcision-info-2014/en/

 

Tags: Guest Speakers · Human Health

Rebecca Gray: Sociology of Epidemiology

February 23rd, 2015 · Comments Off on Rebecca Gray: Sociology of Epidemiology

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Today, I met an epidemiologist. He spoke about disease control: how germs traverse continents, how we respond to global health crises, and how we can prepare for future epidemics, because, “after all,” he said, “they are inevitable.” To begin, he offered a bit of a crash course on HIV in America; while the subject matter was grim, the bottom line felt overwhelmingly hopeful. In a nutshell, we learned that HIV, at one time the leading cause of death for men ages 25-40 in the U.S., is now a condition well-controlled with proper medication. So yes, while HIV remains a gravely serious diagnosis, and continues to spread rapidly in underdeveloped regions of Africa, the vibe of this speech was uplifting, full of the promise of research, breakthrough, and medical revolution.

But I am skeptical. I am skeptical because this crash course glossed over the very gritty history of HIV in America. It glossed over they way AIDS (Auto-Immune Deficiency Disorder) used to be called GRID (Gay-Related Immune Deficiency). It skipped the years that HIV drugs (AZT and others) spent in gridlock, waiting to be clinically tested, because policy makers refused to fund medical initiatives for “perverts” with “homosexual tendencies”. It did not mention that the decline of HIV-related deaths in the U.S. correlated exactly with the mobilization of the gay rights movement. In short, it did not admit that disease control intersects with issues of social justice on nearly every level: race, class, gender, and sexuality.

The outbreaks we hear about, the drugs we are sold, the preventative measures we are asked to take, are carefully calculated. Information can be manipulated to reassure or scare us, to rile us up or calm us down. Our recent preoccupation with the ebola virus is a textbook example of this. As midterm elections drew near, political candidates used a health crisis occurring in Africa as ammunition in an American political debate. Articles citing the ways in which ebola can be contracted, pictures depicting its unsavory symptoms, and bold political promises to end this epidemic pervaded our lives. Then, suddenly, voting season passed, effectively closing the door on ebola discussion. This happened because government officials, now secure in their jobs, could no longer bank on public fear. In fact, our speaker did acknowledge this, and made admirable efforts to include social discussion in his lecture. It is not my intention to discredit him; I understand that in a single hour, it’s impossible to cover the field of epidemiology and all its intersections with sociology entirely. I found his presentation to be smart, well researched, and engaging. Rather, I just hope to use this blog post as a means to discuss the social implications of epidemiology in a way that we were not quite able to in class. Medicine cannot function outside the realm of social intersectionality. To say that medical information and technology are the only roadblocks, or even the largest roadblocks between ourselves and global health solutions is to be sadly mistaken. As important and exciting as medical advancement is, we must also tackle poverty and discrimination when taking on issues of global health. Class, race, gender, sexuality, age, and ableism all affect a person’s access to proper healthcare and health education.

Tags: Guest Speakers · Human Health

Arianne Thomas: My JanPlan Experience – pt. 1

February 22nd, 2015 · Comments Off on Arianne Thomas: My JanPlan Experience – pt. 1

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This JanPlan gave me many unique opportunities, and I learned so much about the human body in so many different ways beyond just classroom lectures. We spent hours in lab studying models, histology slides, real bones, and a real pig heart. We went on “field trips” to the art museum, where we identified different anatomical features in pieces of art, and to the athletic center, where we learned about our own heart rates, respiration, and metabolism. We completed a Grand Rounds project, which is where medical professionals present a patient’s issues and treatment for the purpose of educating medical students as well as other doctors. We were given the opportunity to work with high schoolers interested in the sciences during a mentoring session where we were taught them a little bit about what we were studying in class and helped them plan out science fair project ideas.

Some of my favorite learning experiences organized by Dr. Klepach was bringing in different speakers who talked to us about what they do in their day to day lives and the issues they seek to fix. The first speaker was Dr. Zak Nashed, a radiologist who specializes in peripheral artery disease. PAD is a circulation problem where arteries that supply blood to the extremities get clogged by the hardening of arteries, often times leading to a stroke or a heart attack. It can cause damage to the endothelial lining of the arteries, an increased permeability and adhesion of molecules, and if it goes untreated there could be a complete obstruction. One treatment option is medical management, where the risk factors could be modified (by exercising, losing weight, or stopping smoking) or a pharmacologic intervention could be used to regulate hypercholesterolemia, hypertension, or diabetes. Another treatment option, which Dr. Nashed specializes in, is interventional radiology through endovascular techniques. These are minimally invasive procedures where medical professionals use image guided tools to perform balloon angioplasty and place stents to open up narrowed arteries due to plaque build up. The third and most extreme treatment option is to perform a bypass graft or an amputation.

The other speaker who came to talk to us was Dr. Peter Millard who is an epidemiologist, someone who studies causes and patterns of diseases in different populations. He talked to us about his work with diseases in Africa, making the interesting point that where he worked in Mozambique is about the same distance from Liberia as it is from New York, but in reality New York is a lot closer because there is more traffic between the two places. He explained that geographic proximity is different from travel patterns and the way disease spreads has a lot more to do with traffic than geographic proximity. He also talked about the prevalence of HIV across different parts of Africa, and possible correlation between these rates of HIV and circumcision. Another interesting aspect of epidemiology he talked about was the importance of disease prevention on economic and social levels.

Having these speakers come in to talk with us was an integral part of my learning experience in the Anatomy and Physiology class because it opened my eyes to all the various aspects that the sciences, biology in particular, encompass. Having both parents working in the medical field has always fostered an interest in a profession in the medical field, but I have never had a concrete idea of what I specifically would like to do. These opportunities of having two very different speakers come talk to us made me more aware of the various directions my degree in biology can take me and interested in looking into different careers that I would have never thought about before.

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Tags: Bi265j · Guest Speakers

Cameron Matticks: JanPlan 2015 Internship talk to Bi265j Human A&P

January 31st, 2015 · Comments Off on Cameron Matticks: JanPlan 2015 Internship talk to Bi265j Human A&P

Cameron Matticks, (’15, Cell & Molecular Biology) was the 2015 Bi265j TA and intern. Listen to his talk to the class about his experience below.

Tags: Guest Speakers · Human Health · Internship Talks

Dr. Peter Millard, Epidemiologists Comes to Speak.

January 30th, 2015 · Comments Off on Dr. Peter Millard, Epidemiologists Comes to Speak.

The last day of class we had the pleasure and honor of hosting epidemiologist Dr. Peter Millard, an MD PhD based in Belfast Maine, for a thoroughly engaging hour as he spoke about a wide range of epidemiological issues. The topics covered spanned his work on HIV infection in Africa, to the political, media and social components of disease right here in Maine.

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For all of the students in Bi265j I would like to thank Dr. Millard for graciously donating his time to come and speak to us. Watch his interesting and informative presentation below.

Tags: Guest Speakers

Caitlin Guiney: Nurse Practitioner Internship

January 15th, 2014 · Comments Off on Caitlin Guiney: Nurse Practitioner Internship

Hi everyone! For those of you who don’t know me, I am Caitlin Guiney. I am currently a junior, biology major and art minor from Concord, MA. I took this class last year and loved it. I initially thought coming into college I wanted to be a pediatrician, but through volunteering at Inland Hospital in Waterville, a hospital at home, and talking with people in the medical field my plan has morphed to hopefully become a nurse practitioner (NP).

Thom was extremely helpful in setting up with me this Jan Plan an internship at two different locations so I could continue to learn about the medical field and experience what it is like day to day working in it. On Monday and Tuesday I go to the family care private practice in Belgrade and shadow Dr. Amy Madden and her staff. On Wednesday and Thursday I go to the rheumatology department at Inland Hospital on KMD and shadow NP Marci Lowe. The two different environment provide great contrast to start to narrow down my plan for after college.

 

I had to fill some paperwork on Monday so I began on Tuesday shadowing Dr. Amy. Dr. Amy went to Dartmouth College for both undergrad and medical school. In the practice and Belgrade there are three people practicing two doctors and one FNP, Lisa. The practice is for approximately 3,000 people from the Belgrade area.

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The first patient that Dr. Amy saw was a 60 year old woman, who is a nurse, for her physical. I have always thought physicals are the easiest types of appointments for doctors, but the physicals Dr. Amy had that day were not only a check on the essentials, but opportunity for the patient to air concerns about a lingering problem and/or ask questions. The nurse had feet issues; Dr. Amy diagnosed her with plantar fasciitis. Plantar fasciitis, appropriately named is heel pain caused by when the fibrous band of tissue in the sole of the foot that helps support the arch. When the plantar fascia becomes and inflamed or torn by being overloaded or overstretched it causes small tears where the tissue meets the heel bone. It is common in overweight and pregnant women. It reminded me that health is not about the big decisions, but making every day little decisions like wearing the proper footwear and stretching.

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What surprise me when the nurse whipped out her iPad and had a list of questions she had about things she had seen on the Dr. Oz show. Amy was extremely composed, and it reminded me of grand rounds question section for our presentation in A&P last year. I realized something that makes the patients so comfortable with Amy is her composure and the importance of her confidence to assure the patient and make them feel confident her ability. I found it funny Amy told me that getting Dr. Oz questions are a common experience.

One of my favorite shows is house. And the next patient we saw was a house case according to Amy. The next patient was a 56 year old male carpenter who was losing feeling in arm all at once and then slowly his feeling would return. After perform some strength tests and mobility tests, Amy said the muscle causing the issue was the deltoid muscles fatigue most likely caused by inflammation of the rotator cuff. Amy order blood tests and orthopedic appointment for the man. I am interested to see what the blood tests will show and what the orthopedist might discover because his numbness was not brought on by physical exertion.

The next physical was with a hospital dietitian who has wheat belly. Much of the appoint was Amy asking about her personal life because her life had recently become very stressful which had contributed to stress that had cause her to neglect things she has previously been doing to help her wheat belly. Amy discussed how to minimize the stress and was very sympathetic. Why I want to go into this field because it more challenge than an exam for example when you are giving a problem where there is a list of symptoms and you have to give a diagnose, people are dynamic and complex. There are so many dimensions to health and I believe there is a direct correlation between the mind and the body when one is mental overwhelmed it will one way or another will physical manifest in the body.

The last patient was a man in 50s who had gastrointestinal diabetes. All lot of the time with him was spent making sure he was sticking to his regiment. Also trying to get Maine care, insurance, to pay for his prescriptions, he was having trouble with his insurance arguing that he need his pressure socks covered for because they were something he couldn’t go without. Primary care is much more maintainer of someone’s health, but also there as a support system and advocate. Dr. Amy does an amazing job at all three, especially relentless with the insurance and drug companies, and is a great role model for me.

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Here is the talk that I gave to the Bi265j Human Anatomy and Physiology Class reviewing my experience during the internship.

 

Tags: Guest Speakers · Internship Talks · Uncategorized